medalphabetМедицинский алфавитMedical alphabet2078-56312949-2807ООО «Альфмед»medalphabet-741Research ArticleСтатьиПрименение ацетилсалициловой кислоты в клинической практикеUse of acetylsalicylic acid in clinical practiceЕвдокимоваА. Г.EvdokimovaA. G.noemail@neicon.ruКоваленкоЕ. В.KovalenkoE. V.noemail@neicon.ruЕвдокимовВ. В.EvdokimovV. V.noemail@neicon.ruЖуколенкоЛ. В.ZhukolenkoL. V.noemail@neicon.ruФедороваТ. В.FedorovaT. V.noemail@neicon.ruЛобановаЕ. Г.LobanovaE. G.noemail@neicon.ruФГБОУ ВО «Московский государственный медико-стоматологический университет имени А.И. Евдокимова» Минздрава РоссииРоссияMoscow State Medical and Stomatological University n.a. A.I. EvdokimovRussian Federation201809072018221Современная поликлиника4651Copyright © Евдокимова А.Г., Коваленко Е.В., Евдокимов В.В., Жуколенко Л.В., Федорова Т.В., Лобанова Е.Г., 20182018Евдокимова А.Г., Коваленко Е.В., Евдокимов В.В., Жуколенко Л.В., Федорова Т.В., Лобанова Е.Г.Evdokimova A.G., Kovalenko E.V., Evdokimov V.V., Zhukolenko L.V., Fedorova T.V., Lobanova E.G.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.med-alphabet.com/jour/article/view/741

В статье представлен литературный обзор эффективности ацетилсалициловой кислоты при первичной и вторичной профилактике сердечнососудистых осложнений. Рассмотрены вопросы безопасности и методы профилактики развития осложнений на фоне длительного приема ацетилсалициловой кислоты.

The article presents a literature review of the efficacy of ace-tylsalicylic acid in the primary and secondary prevention of cardiovascular complications. Questions of safety and methods of preventing complications development on the background of long-term intake of acetylsalicylic acid are considered.

ацетилсалициловая кислотапервичная профилактикавторичная профилактикасердечно-сосудистые заболеваниябезопасностьacetylsalicylic acidprimary preventionsecondary preventioncardiovascular diseasessafetyReferencesFusfer V., Sweeny J.M. Aspirin. A historical and contemporary therapeutic overview // Circulation. 2011. Vol. 123. P. 768-778.Fusfer V., Sweeny J.M. Aspirin. A historical and contemporary therapeutic overview // Circulation. 2011. Vol. 123. P. 768-778.Vane J.R., Bakhle Y.S., Botting R.M. Cyclooxygenases 1 and 2 // Ann. Rev. Pharmacol. Toxicol. 1998. Vol. 38. P. 97-120.Vane J.R., Bakhle Y.S., Botting R.M. Cyclooxygenases 1 and 2 // Ann. Rev. Pharmacol. Toxicol. 1998. Vol. 38. P. 97-120.Метелица В.И. Справочник по клинической фармакологии сердечно-сосудистых лекарственных средств. 3-е изд. М., 2005.Метелица В.И. Справочник по клинической фармакологии сердечно-сосудистых лекарственных средств. 3-е изд. М., 2005.Бубнова М.Г. Аспирин в профилактики атеротромбоза и коронарной болезни сердца. Российский кардиологический журнал. № 4. (84). 2010. С. 115-121.Бубнова М.Г. Аспирин в профилактики атеротромбоза и коронарной болезни сердца. Российский кардиологический журнал. № 4. (84). 2010. С. 115-121.Morita I., Schindler M. et. al. Different intracellular locations for prostaglandin endoperoxide H synthase-1 and -2 // J. Biol. Chem. 1995. Vol. 270. P. 10902-10908.Morita I., Schindler M. et. al. Different intracellular locations for prostaglandin endoperoxide H synthase-1 and -2 // J. Biol. Chem. 1995. Vol. 270. P. 10902-10908.Smith W.L. Prostanoid biosynthesis and the mechanism of action // Am. J. Physiol. 1992. Vol. 263. F118-F191.Smith W.L. Prostanoid biosynthesis and the mechanism of action // Am. J. Physiol. 1992. Vol. 263. F118-F191.Grosser N., Schr der H. Aspirin Protects Endothelial Cells From Oxidant Damage Via the Nitric Oxide-cGMP Pathway. Arterios Thromb Vasc Biol 2003; 23: 1345-1348.Grosser N., Schr der H. Aspirin Protects Endothelial Cells From Oxidant Damage Via the Nitric Oxide-cGMP Pathway. Arterios Thromb Vasc Biol 2003; 23: 1345-1348.Sanmuganathan P.S., Gharamani P., Jackson P.R., et al. Aspirin for primary prevention of coronary heart disease: safety and absolute benefit related to coronary risk derived from meta-analysis of randomized trials. Heart 2001; 85: 265-271.Sanmuganathan P.S., Gharamani P., Jackson P.R., et al. Aspirin for primary prevention of coronary heart disease: safety and absolute benefit related to coronary risk derived from meta-analysis of randomized trials. Heart 2001; 85: 265-271.Hansson L., Zanchetti A., Carruthers S. et al. Effects of intensive blood-pressure lowering and low-dose aspirin in patients with hypertension: principal results of the Hypertension Optimal Treatment (HOT) randomized trial. Lancet, 1998; 351: 1755-1762.Hansson L., Zanchetti A., Carruthers S. et al. Effects of intensive blood-pressure lowering and low-dose aspirin in patients with hypertension: principal results of the Hypertension Optimal Treatment (HOT) randomized trial. Lancet, 1998; 351: 1755-1762.Рекомендации по лечению артериальной гипертонии ESH/ESC 2013 Рабочая группа по лечению артериальной гипертонии Европейского общества гипертонии (European Society of Hypertension, ESH) и Европейского общества кардиологов (European Society of Cardiology, ESC). Российский кардиологический журнал 2014, 1 (105): 7-94.Рекомендации по лечению артериальной гипертонии ESH/ESC 2013 Рабочая группа по лечению артериальной гипертонии Европейского общества гипертонии (European Society of Hypertension, ESH) и Европейского общества кардиологов (European Society of Cardiology, ESC). Российский кардиологический журнал 2014, 1 (105): 7-94.Collaborative Group of the Primary Prevention Project (PPP). Low-dose aspirin and vitamin E in people at cardiovascular risk: a randomized trial in general practice // Lancet. 2001. Vol. 357. P. 89-95.Collaborative Group of the Primary Prevention Project (PPP). Low-dose aspirin and vitamin E in people at cardiovascular risk: a randomized trial in general practice // Lancet. 2001. Vol. 357. P. 89-95.Ridker P.M., Cook N.R., Lee I.M. et al. A randomized trial of low-dose aspirin in the primary prevention of cardiovascular disease in women // N Engl J Med. 2005. Vol. 352. P. 1293-1304.Ridker P.M., Cook N.R., Lee I.M. et al. A randomized trial of low-dose aspirin in the primary prevention of cardiovascular disease in women // N Engl J Med. 2005. Vol. 352. P. 1293-1304.Antithrombotic Trialists’ (ATT) Collaboration; Baigent C., Blackwell L., Collins R. et al. Aspirin in the primary and secondary prevention of vascular disease: collaborative meta-analysis of individual participant data from randomised trials // Lancet. 2009; 373: 1849-1860.Antithrombotic Trialists’ (ATT) Collaboration; Baigent C., Blackwell L., Collins R. et al. Aspirin in the primary and secondary prevention of vascular disease: collaborative meta-analysis of individual participant data from randomised trials // Lancet. 2009; 373: 1849-1860.https://jamanetwork.com/journals/jama/fullarticle/1936801.https://jamanetwork.com/journals/jama/fullarticle/1936801.Juul-Moller S., Edvardsson N., Jahnmatz B. et al. Double-blind trial of aspirin in primary prevention of myocardial infarction in patients with chronic angina pectoris. Lancet 1992; 340: 1412-1425.Juul-Moller S., Edvardsson N., Jahnmatz B. et al. Double-blind trial of aspirin in primary prevention of myocardial infarction in patients with chronic angina pectoris. Lancet 1992; 340: 1412-1425.Antiplatelet Trial'ists Collaboration. Collaborative overview of randomized of antiplatelet therapy: I Prevention of death, myocardial infarction, and stroke by prolonged anti-platelet in various categories of patients. BMJ 1994; 308: 81-106.Antiplatelet Trial'ists Collaboration. Collaborative overview of randomized of antiplatelet therapy: I Prevention of death, myocardial infarction, and stroke by prolonged anti-platelet in various categories of patients. BMJ 1994; 308: 81-106.ISIS-2 (Second International Study of Infarct Survival) Collaborative Group. Short- and long-term risk reduction in vascular events with aspirin. Expert Rev Cardiovasc Ther 2008; 6 (1): 95-107.ISIS-2 (Second International Study of Infarct Survival) Collaborative Group. Short- and long-term risk reduction in vascular events with aspirin. Expert Rev Cardiovasc Ther 2008; 6 (1): 95-107.Collaborative meta-analysis of randomized of antiplatelet therapy for prevention of death, myocardial infarction, and stroke in high risk patients. BMJ 2002; 342: 71-86.Collaborative meta-analysis of randomized of antiplatelet therapy for prevention of death, myocardial infarction, and stroke in high risk patients. BMJ 2002; 342: 71-86.Lindblad B, Persson N, Takolander R., Bergqvist D. Does low-dose acetylsalicylic acid prevent stroke after carotid surgery? A double-blind, placebo-controlled randomized trial. Stroke. 1993; 24: 1125 trial. Stroke. 1993; 24: 1125-1128.Lindblad B, Persson N, Takolander R., Bergqvist D. Does low-dose acetylsalicylic acid prevent stroke after carotid surgery? A double-blind, placebo-controlled randomized trial. Stroke. 1993; 24: 1125 trial. Stroke. 1993; 24: 1125-1128.Taylor D.W., Barnett H.J.M., Haynes R.B. et al. Low-dose and high-dose acetylsalicylic acid for patients undergoing carotid endarterec-tomy: a randomised controlled trial. Lancet. 1999; 353: 2179 cet. 1999; 353: 2179-2184.Taylor D.W., Barnett H.J.M., Haynes R.B. et al. Low-dose and high-dose acetylsalicylic acid for patients undergoing carotid endarterec-tomy: a randomised controlled trial. Lancet. 1999; 353: 2179 cet. 1999; 353: 2179-2184.Mohr J.P., Thompson J.L., Lazar R.M. et al. A comparison of warfarin and aspirin for the prevention of recurrent ischemic stroke. N Engl J Med. 2001; 345: 1444-51.Mohr J.P., Thompson J.L., Lazar R.M. et al. A comparison of warfarin and aspirin for the prevention of recurrent ischemic stroke. N Engl J Med. 2001; 345: 1444-51.Diener H.C., Bogousslavsky J., Brass L.M., et al. Aspirin and clopidogrel compared with clopidogrel alone after recent ischaemic stroke or transient ischaemic attack in high-risk patients (MATCH): randomised, double-blind, placebo controlled trial. Lancet. 2004; 364: 331-7.Diener H.C., Bogousslavsky J., Brass L.M., et al. Aspirin and clopidogrel compared with clopidogrel alone after recent ischaemic stroke or transient ischaemic attack in high-risk patients (MATCH): randomised, double-blind, placebo controlled trial. Lancet. 2004; 364: 331-7.Bhatt D.L., Topol E.J. Clopidogrel added to aspirin versus aspirin alone in secondary prevention and high-risk primary prevention: Rationale and design of the Clopidogrel for High Athero-thrombotic Risk and Ischemic Stabilization, Management, and Avoidance (CHARISMA) trial. Am Heart J 2004; 148:263-8.Bhatt D.L., Topol E.J. Clopidogrel added to aspirin versus aspirin alone in secondary prevention and high-risk primary prevention: Rationale and design of the Clopidogrel for High Athero-thrombotic Risk and Ischemic Stabilization, Management, and Avoidance (CHARISMA) trial. Am Heart J 2004; 148:263-8.Diener H.C., Cunha L., Forbes C., et al. European Stroke Prevention Study. 2. Dipyridamole and acetylsalicylic acid in vention Study. 2. Dipyridamole and acetylsalicylic acid in the secondary prevention of stroke. J Neurol Sci. 1996; 143:1-13.Diener H.C., Cunha L., Forbes C., et al. European Stroke Prevention Study. 2. Dipyridamole and acetylsalicylic acid in vention Study. 2. Dipyridamole and acetylsalicylic acid in the secondary prevention of stroke. J Neurol Sci. 1996; 143:1-13.Sacco RL, Diener HC, Yusuf S, et al. Aspirin and extended-release dipyridamole versus clopidogrel for recurrent stroke. N Engl J Med. 2008; 359: 1238-51.Sacco RL, Diener HC, Yusuf S, et al. Aspirin and extended-release dipyridamole versus clopidogrel for recurrent stroke. N Engl J Med. 2008; 359: 1238-51.Верткин А.A., Аристархова О.Ю., Адонина Е.В. и др. Безопасность и фармакоэкономическая эффективность применения различных препаратов ацетилсалициловой кислоты у пациентов с ИБС // РМЖ. 2009; 17 (9): 570-575.Верткин А.A., Аристархова О.Ю., Адонина Е.В. и др. Безопасность и фармакоэкономическая эффективность применения различных препаратов ацетилсалициловой кислоты у пациентов с ИБС // РМЖ. 2009; 17 (9): 570-575.Expert Consensus Document on the use of antiplatelet agents. The Task Force on the use of antiplatelet agents in patients with atherosclerotic cardiovascular disease of the European Society of Cardiology // Eur. Heart J. 2004. Vol. 25. P. 166-181.Expert Consensus Document on the use of antiplatelet agents. The Task Force on the use of antiplatelet agents in patients with atherosclerotic cardiovascular disease of the European Society of Cardiology // Eur. Heart J. 2004. Vol. 25. P. 166-181.Valgimigli M., Bueno H., Byrne R.A. et al. 2017 ESC focused update on dual antiplatelet therapy in coronary artery disease developed in collaboration with EACTS. Eur Heart J. 2017; 0: 1-48. DOI: 10.1093/eurbeartj/ebx419.Valgimigli M., Bueno H., Byrne R.A. et al. 2017 ESC focused update on dual antiplatelet therapy in coronary artery disease developed in collaboration with EACTS. Eur Heart J. 2017; 0: 1-48. DOI: 10.1093/eurbeartj/ebx419.Farrell B., Godwin J., Richards S., Warlow C. The United Kingdom transient ischaemic attack (UK-TIA) aspirin trial: final results. J Neurol Neurosurg Psychiatry 1991; 54: 1044-1054.Farrell B., Godwin J., Richards S., Warlow C. The United Kingdom transient ischaemic attack (UK-TIA) aspirin trial: final results. J Neurol Neurosurg Psychiatry 1991; 54: 1044-1054.De Schryver E.L., Algra A., Van Gijn J. Dipyridamole for preventing stroke and other vascular events in patients with vascular disease. Cochrane Database Syst Rev 2007; 3: CD 001820.De Schryver E.L., Algra A., Van Gijn J. Dipyridamole for preventing stroke and other vascular events in patients with vascular disease. Cochrane Database Syst Rev 2007; 3: CD 001820.Sacco R.L., Diener H.C., Yusuf S., Cotton D., Ounpuu S., Lawton W.A., Palesch Y., Martin R.H., Albers G.W., Bath P., Bornstein N., Chan B.P., Chen S.T., Cunha L., Dahlof P., De Keyser J., Donnan G.A., Estol C., Gorelick P., Gu V., Hermansson K., Hilbrich L., Kaste M., Lu C., Machnig T., Pais P., Roberts R., Skvortsova V., Teal P., Toni D., Vandermaelen C., Voigt T., Weber M., Yoon B.W. Aspirin and extended-release dipyridamole versus clopidogrel for reccurent stroke. N. Eng. J. Med. 2008; 359:1238-251.Sacco R.L., Diener H.C., Yusuf S., Cotton D., Ounpuu S., Lawton W.A., Palesch Y., Martin R.H., Albers G.W., Bath P., Bornstein N., Chan B.P., Chen S.T., Cunha L., Dahlof P., De Keyser J., Donnan G.A., Estol C., Gorelick P., Gu V., Hermansson K., Hilbrich L., Kaste M., Lu C., Machnig T., Pais P., Roberts R., Skvortsova V., Teal P., Toni D., Vandermaelen C., Voigt T., Weber M., Yoon B.W. Aspirin and extended-release dipyridamole versus clopidogrel for reccurent stroke. N. Eng. J. Med. 2008; 359:1238-251.Berger J.S., Krantz M.J., Kittelson J.M., Hiatt W.R. Aspirin for the prevention of cardiovascular events in patients with peripheral artery disease: a meta-analysis of randomized trials. JAMA 2009; 301: 1909-1919.Berger J.S., Krantz M.J., Kittelson J.M., Hiatt W.R. Aspirin for the prevention of cardiovascular events in patients with peripheral artery disease: a meta-analysis of randomized trials. JAMA 2009; 301: 1909-1919.Bates E.R., Babb J.D., Casey D.E. Jr, et al. American College of Cardiology Foundation; American Society of Interventional & Therapeutic Neuroradiology; Society for Cardiovascular Angiography and Interventions; Society for Vascular Medicine and Biology; Society of Interventional Radiology, ACCF/ SCAI/SVMB/SIR/ASITN 2007 clinical expert consensus document on carotid stenting: a report of the American College of Cardiology Foundation Task Force on Clinical Expert Consensus Documents (ACCF/SCAI/SVMB/SIR/ ASITN Clinical Expert Consensus Document Committee on Carotid Stenting). J Am Coll Cardiol. 2007;49: 126-170.Bates E.R., Babb J.D., Casey D.E. Jr, et al. American College of Cardiology Foundation; American Society of Interventional & Therapeutic Neuroradiology; Society for Cardiovascular Angiography and Interventions; Society for Vascular Medicine and Biology; Society of Interventional Radiology, ACCF/ SCAI/SVMB/SIR/ASITN 2007 clinical expert consensus document on carotid stenting: a report of the American College of Cardiology Foundation Task Force on Clinical Expert Consensus Documents (ACCF/SCAI/SVMB/SIR/ ASITN Clinical Expert Consensus Document Committee on Carotid Stenting). J Am Coll Cardiol. 2007;49: 126-170.Lanas A. Cyclo-oxygenase-1/cyclo-oxygen-ase-2 non selective nonsteroidal anti-inflammatory drugs: epidemiology of gastrointer-stinal events. Dig Liver Dis 2002;33 (Suppl.2): S 29-S 34.Lanas A. Cyclo-oxygenase-1/cyclo-oxygen-ase-2 non selective nonsteroidal anti-inflammatory drugs: epidemiology of gastrointer-stinal events. Dig Liver Dis 2002;33 (Suppl.2): S 29-S 34.Raderick PJ, Wilkes HC, Meade TW. The gastrointestinal toxicity of aspirin: an overview of randomized controlled trials. Br J ClinPharmacol 1993; 35: 219-226.Raderick PJ, Wilkes HC, Meade TW. The gastrointestinal toxicity of aspirin: an overview of randomized controlled trials. Br J ClinPharmacol 1993; 35: 219-226.Cryer B. Reducing the risk of gastrointestinal bleeding with antiplatelet therapies. N. Engl. J. Med. 2005; 352: 287-293.Cryer B. Reducing the risk of gastrointestinal bleeding with antiplatelet therapies. N. Engl. J. Med. 2005; 352: 287-293.Минушкина A. О. Препараты ацетилсалициловой кислоты у больных с бессимптомным атеросклерозом: риск или польза? Consilium Medicum. 2015; 17(10):57-60.Минушкина A. О. Препараты ацетилсалициловой кислоты у больных с бессимптомным атеросклерозом: риск или польза? Consilium Medicum. 2015; 17(10):57-60.Zhang S., Qing Q., Bai Y., Rebamipide helps defend against nonsteroidal anti-inflammatory drugs induced gastroenteropathy: a systematic review and meta-analysis. Dig Dis Sci. 2013; 7: 1991-2000. DOI: 10.3748/wjg.v17.i6.5117.Zhang S., Qing Q., Bai Y., Rebamipide helps defend against nonsteroidal anti-inflammatory drugs induced gastroenteropathy: a systematic review and meta-analysis. Dig Dis Sci. 2013; 7: 1991-2000. DOI: 10.3748/wjg.v17.i6.5117.Насонов Е.A., Ивашкин В.Т., Яхно Н.Н., Мартынов А.И., Арутюнов Г.П., Каратеев А.Е., Алексеева A.И., Чичасова Н.В., Евсеев М.А., Кукушкин М.A., Аила А.М., Ребров А.П., Новикова Д.С., Копенкин С.С., Абузарова Г.Р., Скоробогатых К.В., Аапина Т.A., Попкова Т.В. Проект Национальных клинических рекомендаций (основные положения) Ассоциации ревматологов России, Российской гастроэнтерологической ассоциации, Российского общества по изучению боли «Рациональное использование нестероидных противовоспалительных препаратов» (По результатам совещания группы экспертов, г. Москва, 01.04.2017). Рос. журн. гастроэнтерол., гепатол., колопроктол. 2017;27 (5): 69-75.Насонов Е.A., Ивашкин В.Т., Яхно Н.Н., Мартынов А.И., Арутюнов Г.П., Каратеев А.Е., Алексеева A.И., Чичасова Н.В., Евсеев М.А., Кукушкин М.A., Аила А.М., Ребров А.П., Новикова Д.С., Копенкин С.С., Абузарова Г.Р., Скоробогатых К.В., Аапина Т.A., Попкова Т.В. Проект Национальных клинических рекомендаций (основные положения) Ассоциации ревматологов России, Российской гастроэнтерологической ассоциации, Российского общества по изучению боли «Рациональное использование нестероидных противовоспалительных препаратов» (По результатам совещания группы экспертов, г. Москва, 01.04.2017). Рос. журн. гастроэнтерол., гепатол., колопроктол. 2017;27 (5): 69-75.Оганезова А.Г. Ацетилсалициловая кислота от А до Я: азбука применения в кардиологии // РМЖ. 2018. № 1 (II). С. 104-109.Оганезова А.Г. Ацетилсалициловая кислота от А до Я: азбука применения в кардиологии // РМЖ. 2018. № 1 (II). С. 104-109.

The authors declare that there are no conflicts of interest present.